Healthcare Provider Details

I. General information

NPI: 1568777068
Provider Name (Legal Business Name): KATHLEEN NAJDEK REGISTERED NURSE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHLEEN LUNDE RN

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12000 SW MAIN ST
TIGARD OR
97223-6218
US

IV. Provider business mailing address

PO BOX 23933
TIGARD OR
97281-3933
US

V. Phone/Fax

Practice location:
  • Phone: 503-347-8042
  • Fax: 503-579-9344
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number60099817
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number076036037RN
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberTSPA PP-12
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: